Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study.
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GBD 2017 US Neurological Disorders Collaborators, Feigin Valery L, Vos Theo, Alahdab Fares, Amit Arianna Maever L, Bärnighausen Till Winfried, Beghi Ettore, Beheshti Mahya, Chavan Prachi P, Criqui Michael H, Desai Rupak, Dhamminda Dharmaratne Samath, Dorsey E Ray, Wilder Eagan Arielle, Elgendy Islam Y, Filip Irina, Giampaoli Simona, Giussani Giorgia, Hafezi-Nejad Nima, Hole Michael K, Ikeda Takayoshi, Owens Johnson Catherine, Kalani Rizwan, Khatab Khaled, Khubchandani Jagdish, Kim Daniel, Koroshetz Walter J, Krishnamoorthy Vijay, Krishnamurthi Rita V, Liu Xuefeng, Lo Warren David, Logroscino Giancarlo, Mensah George A, Miller Ted R, Mohammed Salahuddin, Mokdad Ali H, Moradi-Lakeh Maziar, Morrison Shane Douglas, Shivamurthy Veeresh Kumar N, Naghavi Mohsen, Nichols Emma, Norrving Bo, Odell Christopher M, Pupillo Elisabetta, Radfar Amir, Roth Gregory A, Shafieesabet Azadeh, Sheikh Aziz, Sheikhbahaei Sara, Shin Jae Il, Singh Jasvinder A, Steiner Timothy J, Stovner Lars Jacob, Wallin Mitchell Taylor, Weiss Jordan, Wu Chenkai, Zunt Joseph Raymond, Adelson Jaimie D, Murray Christopher J L
Аннотация
OBJECTIVE: To present burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017.
DESIGN, SETTING, AND PARTICIPANTS: This is a systematic analysis of the Global Burden of Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were analyzed: stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis, and tetanus.
EXPOSURES: Any of the 14 listed neurological diseases.
MAIN OUTCOME AND MEASURE: Absolute numbers in detail by age and sex and age-standardized rates (with 95% uncertainty intervals) were calculated.
RESULTS: The 3 most burdensome neurological disorders in the US in terms of absolute number of DALYs were stroke (3.58 [95% uncertainty interval [UI], 3.25-3.92] million DALYs), Alzheimer disease and other dementias (2.55 [95% UI, 2.43-2.68] million DALYs), and migraine (2.40 [95% UI, 1.53-3.44] million DALYs). The burden of almost all neurological disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as DALYs) increased from 1990 to 2017, largely because of the aging of the population. Exceptions for this trend included traumatic brain injury incidence (-29.1% [95% UI, -32.4% to -25.8%]); spinal cord injury prevalence (-38.5% [95% UI, -43.1% to -34.0%]); meningitis prevalence (-44.8% [95% UI, -47.3% to -42.3%]), deaths (-64.4% [95% UI, -67.7% to -50.3%]), and DALYs (-66.9% [95% UI, -70.1% to -55.9%]); and encephalitis DALYs (-25.8% [95% UI, -30.7% to -5.8%]). The different metrics of age-standardized rates varied between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while northern states had a relatively higher burden of multiple sclerosis and eastern states had higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache, and meningitis, encephalitis, and tetanus.
CONCLUSIONS AND RELEVANCE: There is a large and increasing burden of noncommunicable neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in particular neurological disorders across the US states. The information reported in this article can be used by health care professionals and policy makers at the national and state levels to advance their health care planning and resource allocation to prevent and reduce the burden of neurological disorders.